Objective This study aims to investigate the correlation between serum IL-6 expression levels and the occur-rence of pulmonary infection in patients with multiple myeloma(MM).Methods This study enrolled a total of 160 MM patients diagnosed with multiple myeloma(MM group)and 40 healthy controls(Control group)from the Department of Hematology of the First Affiliated Hospital of Xinxiang Medical University between January 2021 and August 2022.With-in the MM group,patients were divided into an infected group(n=65)and an uninfected group(n=95)according to the incidence of pulmonary infection during chemotherapy.Respiratory secretions were subjected to bacterial culture and identification.Risk factors of pulmonary infection in MM patients during chemotherapy period was analyzed.The clinical value of serum IL-6 expression levels in predicting the incidence of pulmonary infection during chemotherapy in MM pa-tients was assessed using ROC curve analysis.Results Compared to the control group,the serum IL-6 expression level in the MM group significantly increased[(76.45±6.59)mg/mL vs.(34.23±4.34)mg/mL,t=38.449,P<0.001].Among the infected group,a total of 78 strains of pathogenic bacteria were detected,with gram-positive bacteria account-ing for 52.56%(41/78),gram-negative bacteria accounting for 43.59%(34/78),and fungi accounting for 3.85%(3/78).Logistic regression analysis showed that Durie-Salmon stage,international staging system stage,agranulocyto-sis,and IL-6 were identified as influence factors for pulmonary infection during the chemotherapy period in MM patients.The area under the curve for serum IL-6 in predicting pulmonary infection during chemotherapy in MM patients was 0.924.The diagnostic sensitivity and specificity were 89.35%and 93.22%,respectively.Conclusion The serum expression level of IL-6 is significantly increased in MM patients.The pre-chemotherapy serum IL-6 expression level in MM patients can be used as a serological marker to predict the incidence of pulmonary infection during their chemotherapy period.